I am presenting my view on how to approach the difficult subject of dyspepsia, based on my personal experience and the writings and teachings of Howard M. Spiro. Symptoms arising from the esophagus, and called esophageal dyspepsia, are separated from symptoms arising from the stomach, designated as gastroduodenal dyspepsia. The holistic approach to patients with dyspepsia, and designated Spiro syndrome, is the main purpose of this report. I am introducing a newly defined classification, and criteria, using an intechangeable, standardized nomenclature, to be used by the clinician, endoscopist, and pathologist for diagnosing and managing the causes of gastroduodenal dyspepsia. There are five clinical/endoscopic/histological categories to be considered as possible causes of gastroduodenal dyspepsia. Often these entities are found to be asymptomatic, or a combination may cause symptoms: (1) idiopathic dyspepsia – normal endoscopy and histology; (2) congestive gastropathy/duodenopathy; (3) gastritis/duodenitis; (4) peptic ulcer crater; and (5) gastric cancer. I believe this holistic, unifying approach to diagnosis and management of dyspepsia will enhance the communication between physicians and help standardize the terminology for clinical investigatio